Contraindications to vasoconstrictors in dentistry: Part I

́russe, Re ́nald Pe; Goulet, J.; Turcotte, J Y

doi:10.1016/0030-4220(92)90365-w

Cited by 97 publications

(51 citation statements)

References 67 publications

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“…While some have reported no significant changes in either blood pressure (systolic and diastolic) or heart rate, others did and some authors have suggested that changes are dependent upon the injected vasoconstrictor dose [21]. Dionne et al [22] found that after the administration of 5.4 ml of 2 % lidocaine with adrenaline 1:100,000, taking care to avoid intravascular injection, the heart rate was increased in 19 % of the cases, and cardiac output in up to 30 %.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have suggested that while adrenaline injected as a vasoconstrictor is associated with transient effects in normotensive patients, hemodynamic complications could develop in uncontrolled hypertensive subjects, with possible cardiovascular accidents [25], though such problems would be related to the dose of vasoconstrictor administered, and to the local anaesthetic used [21]. The result from this study showed that the administration of 3.6 ml of lidocaine 1:100,000 did not result in a statistically significant increase in systolic blood pressure while diastolic pressure and heart rates were largely unaffected.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions

Akinmoladun

Okoje

Akinosun

et al. 2012

J. Maxillofac. Oral Surg.

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Introduction The systemic effects of adrenaline administered during dental local anesthesia have been the subject of many studies. The purpose of this study was to investigate the haemodynamic and metabolic effects attributable to adrenaline injected during local anesthesia in dental extraction patients. Methods Apparently medically fit patients were included and randomized into two groups. Participants had breakfast before coming in for tooth extraction. The weight, height, blood pressure and pulse rate were measured and blood sample taken before administration of local anaesthetic injections. Blood pressure, pulse and blood sample were again taken at 15 and 30 min. Results While the adrenaline group showed a modest increase between pre-and post-drug administration states, the control group showed no difference in median systolic blood pressures. Both groups showed a slight increase in diastolic blood pressure observed between pre-and postdrug administration states. Also both groups showed no significant difference in median pulse rate throughout. Although blood glucose values were widely dispersed in the pre-drug administration state in both groups, the control group showed no difference in median values throughout. However, a modest increase was observed in the adrenaline group between pre-and post-drug administration states, which persisted beyond 30 min. Conclusion The patients treated with local anesthesia with adrenaline showed a response similar to that observed in the control group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions

Akinmoladun

Okoje

Akinosun

et al. 2012

J. Maxillofac. Oral Surg.

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“…Avoidance of epinephrine would appear to be a sensible precaution due to the possible cardiac chronotropic, inotropic and arrhythmogenic properties, effects which may be exaggerated in some patients, such as cardiac transplant recipients. 4,5 However, it has also been suggested that felypressin at high concentrations may produce coronary vasoconstriction/ischaemia and its use in such cardiac conditions could also be contraindicated. 1,6 A plain solution, such as 4% prilocaine, is possibly more appropriate in such patients, although selected by only 7% of practitioners -14% selecting lidocaine.…”

Section: Medical Conditionsmentioning

confidence: 99%

A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control

Corbett

Ramacciato²,

Groppo³

et al. 2005

Br Dent J

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Objective The aim of this study was to identify which local anaesthetic solutions were used by general dental practitioners in the United Kingdom and to determine selection criteria. In addition, differences in anaesthetic choice between recent graduates (≤5 years) and more experienced practitioners were investigated. Material and methods Five hundred and six general dental practitioners attending postgraduate courses on pain control in dentistry completed a questionnaire. Participants were asked to indicate year and place of qualification, anaesthetic solutions available in their surgeries and criteria used in the choice of anaesthetic. In addition, the respondents were asked to indicate choice of local anaesthetic in a number of common medical conditions. Questionnaires were distributed and collected immediately prior to the start of the course presentation and participants were not asked to indicate whether the selection decisions were teaching, experience or evidence based. Data were analysed by using the Chi-square test. Results Lidocaine with epinephrine was the most widely available solution among this group of practitioners (94%), the second most common solution was prilocaine with felypressin (74%). The majority of practitioners had two or more solutions available. Practitioners who qualified within the last five years (14%) were more likely to have articaine available, the most recently introduced local anaesthetic into the UK (p = 0.04, one degree of freedom). Common medical conditions lead to a modification in anaesthetic selection: the use of prilocaine/felypressin increases in the majority of circumstances, although it is avoided in pregnant females by recent graduates. Conclusions Lidocaine/epinephrine continues to be the most common anaesthetic solution used by this group of UK general practitioners. The primary criterion for selection of an anaesthetic agent was perceived efficacy. Prilocaine/felypressin is commonly selected as an alternative solution in the presence of common medical conditions.

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“…Some authors hypothesize that increased heart rate and alterations in blood pressure in dental procedures owing to endogenous catecholamine release from the adrenal medulla result from emotional stress, anxiety and pain but not from a pharmacologic process (15)(16)(17)(18)(19). However, other authors consider that cardiovascular response to dental treatment under local anesthesia may be further influenced by the anesthetic used (20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Holter ECG assessment of the effects of three different local anesthetic solutions on cardiovascular system in the sedated dental patients with coronary artery disease

Zeytinoğlu¹,

Tuncay²,

Akay³

et al. 2013

Anadolu Kardiyol Derg

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Holter ECG assessment of the effects of three different local anesthetic solutions on cardiovascular system in the sedated dental patients with coronary artery disease ABSTRACTObjective: The purpose of the study is to compare the effects of lidocaine alone, epinephrine-combined lidocaine and prilocaine with octapressin on the cardiovascular system during minor oral surgery of sedated cardiac dental patients under local anesthesia.Methods: Connected to a Holter electrocardiogram (ECG) monitor for a total of 5 hours starting 1 hour before the procedure, twenty patients with high risk of coronary artery disease were included in the prospective cohort study. All the patients had three operations at 3 different appointments with at least one-week intervals and each operation was performed under local anesthesia achieved by 3.6 mL of 3% prilocaine with octapressin, 3.6 mL of 2% lidocaine with 1:80.000 epinephrine and 3.6 mL of 2% lidocaine without a vasoconstrictor. Data of the Holter ECG device assessed at the end of every hour and evaluated statistically. Repeated measures ANOVA, Friedman test, and Wilcoxon signed ranks test were used to perform statistical analysis.Results: Heart-rate showed significant differences between lidocaine with epinephrine and pure lidocaine in an hour following the injection (p<0.05 for all). Cardiac rhythm showed significant differences between prilocaine with octapressin and pure lidocaine at the second hour after its administration (p<0.05 for all). There were no significant differences between 3 local anesthetics in terms of ST segment deviation. Conclusion: In minor oral operation on the sedated patients with cardiac disease, the use of 3.6 mL or a less amount of local anesthetic injection containing epinephrine appears to be a predictable and safe method. (Anadolu Kardiyol Derg 2013; 13: 480-5)

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Contraindications to vasoconstrictors in dentistry: Part I

Cited by 97 publications

References 67 publications

Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions

Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions

A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control

Holter ECG assessment of the effects of three different local anesthetic solutions on cardiovascular system in the sedated dental patients with coronary artery disease

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